Notice of Privacy Practices

This notice describes how medical information about you may be used and disclosed, and how you can get access to this information. Please review it carefully.

Dipsu D. Patel, MD is required by law to protect the privacy of your health information, to give you this notice describing our privacy practices, and to follow the terms of the notice currently in effect.

How We May Use or Disclose Your Health Information

We keep a record of the care we provide you, and we may use and disclose that information in the following ways.

Treatment. We use your health information to provide you with medical care and to coordinate that care. We may share it with other providers involved in your treatment, including hospitals, surgery centers, laboratories, imaging facilities, and referring or consulting physicians.

Payment. We may use and disclose your health information to bill and collect payment from you, your health plan, or another party responsible for your care. This can include confirming coverage, obtaining prior authorization, and providing information about the services you received.

Health Care Operations. We may use and disclose your health information to run the practice, review the quality of care we provide, train staff, and work with our business associates. Business associates are required by contract to protect your information.

Appointment Reminders. We may contact you to remind you of a scheduled appointment or to tell you about test results, treatment options, or other health-related services.

Sign-In Sheets. We may use your name on a sign-in sheet or call your name in the waiting area.

Family and Others Involved in Your Care. We may share information with a family member, friend, or other person you identify as involved in your care or payment for your care. If you are present, we will give you the chance to object first. If you are not present or are unable to agree, we will use our judgment about whether the disclosure is in your best interest.

As Required by Law. We will disclose your health information when federal, state, or local law requires it.

Public Health Activities. We may disclose your health information to public health authorities for purposes such as preventing or controlling disease, reporting births and deaths, reporting reactions to medications or problems with medical devices, and reporting suspected abuse, neglect, or domestic violence.

Health Oversight Activities. We may disclose your health information to agencies that oversee the health care system, for audits, investigations, inspections, and licensure.

Judicial and Administrative Proceedings. We may disclose your health information in response to a court or administrative order, and in some cases in response to a subpoena or discovery request.

Law Enforcement. We may disclose your health information to law enforcement officials for purposes permitted by law, such as responding to a court order or identifying a suspect, witness, or missing person.

Coroners, Medical Examiners, and Funeral Directors. We may disclose health information to help identify a deceased person or determine a cause of death.

Organ and Tissue Donation. We may disclose health information to organizations that handle organ, eye, or tissue procurement and transplantation.

To Prevent a Serious Threat. We may use or disclose your health information when necessary to prevent a serious threat to your health and safety or to the health and safety of others.

Specialized Government Functions. We may disclose health information for military and veterans’ activities, national security and intelligence activities, protective services, and to correctional institutions if you are an inmate.

Workers’ Compensation. We may disclose health information as authorized by workers’ compensation laws.

Change of Ownership. If this practice is sold or merged with another organization, your health information may become the property of the new owner, though you would keep the right to request that your records be transferred to another practice.

Breach Notification. We will notify you if a breach occurs that compromises the privacy or security of your health information.

Uses and Disclosures That Require Your Written Authorization

We will not sell your health information, use it for marketing purposes that require authorization, or disclose it in any way not described in this notice without your written authorization. If you give us an authorization, you may revoke it in writing at any time, and we will stop using or disclosing your information for the purposes covered by that authorization. We cannot take back disclosures we have already made.

Your Rights

Right to request restrictions. You may ask us to limit how we use or disclose your health information for treatment, payment, or health care operations. We are not required to agree to every request. We must agree to a request to withhold information from your health plan when you have paid for the service in full and out of pocket.

Right to request confidential communications. You may ask us to contact you in a specific way or at a specific address, such as by mail to a particular location. We will accommodate reasonable written requests without asking why.

Right to inspect and copy. You may ask to see and get a copy of your health information, including an electronic copy when we keep it electronically. We may charge a reasonable, cost-based fee. We may deny a request in limited circumstances, and you may ask for that denial to be reviewed.

Right to request an amendment. If you believe information in your record is incorrect or incomplete, you may ask us in writing to amend it and tell us why. We may deny the request if the information is accurate and complete, or if we did not create it. If we deny it, you may submit a statement of disagreement that becomes part of your record.

Right to an accounting of disclosures. You may ask for a list of the times we shared your health information. The list does not include disclosures made for treatment, payment, or health care operations, disclosures you authorized, or certain other disclosures permitted by law.

Right to a paper copy of this notice. You may ask for a paper copy of this notice at any time, even if you agreed to receive it electronically.

Right to choose someone to act for you. If you have given someone medical power of attorney, or if someone is your legal guardian, that person can exercise your rights and make choices about your health information.

Changes to This Notice

We may change this notice at any time. A revised notice will apply to health information we already have as well as information we receive after the change. The current notice will be posted in our offices and on this website, and the effective date appears at the top of this page.

Questions and Complaints

If you have questions about this notice, or if you believe your privacy rights have been violated, contact our office:

• Email: dr@drpatelcardiology.com
• Clear Lake City: (832) 632-1764 – 1240 Clear Lake City Blvd, Suite 200, Houston, TX 77062
• Texas City: (409) 945-5444 – 6807 Emmett F. Lowry Expy, Suite 108, Texas City, TX 77591

Office hours are Monday through Friday, 9 AM to 5 PM.

You may also file a complaint with the U.S. Department of Health and Human Services, Office for Civil Rights:

• Online: hhs.gov/hipaa/filing-a-complaint
• Email: OCRMail@hhs.gov

We will not retaliate against you for filing a complaint.